Korean J Orthod.  2015 Jan;45(1):47-56. 10.4041/kjod.2015.45.1.47.

Multidisciplinary correction of anterior open bite relapse and upper airway obstruction

Affiliations
  • 1Neuroscience Department, University of Padova, Padova, Italy. antonio.gracco@unipd.it
  • 2Private Practice, Padova, Italy.
  • 3Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
  • 4Department of Orthodontics, University of Bologna, Bologna, Italy.

Abstract

A 27-year-old man presented an anterior open bite relapse. He had low tongue posture positioned anteriorly at rest and during swallowing and reported chronic difficulty in nose breathing. Head cone-beam computed tomography revealed nasal septum deviation, right turbinate hypertrophy, and left maxillary sinus congestion, which were thought to contribute to the breathing problem, encourage the improper tongue posture, and thereby cause the relapse. Multidisciplinary treatment involving an otorhinolaryngologist, an orthodontist, and a periodontist resolved the upper airway obstruction and corrected the malocclusion. The follow-up examination after 3 years 5 months demonstrated stable results.

Keyword

Airway; Relapse; Anterior open bite

MeSH Terms

Adult
Airway Obstruction*
Cone-Beam Computed Tomography
Deglutition
Estrogens, Conjugated (USP)
Follow-Up Studies
Head
Humans
Hypertrophy
Malocclusion
Maxillary Sinus
Nasal Septum
Nose
Open Bite*
Posture
Recurrence*
Respiration
Tongue
Turbinates
Estrogens, Conjugated (USP)

Figure

  • Figure 1 Pretreatment photographs.

  • Figure 2 Pretreatment dental digital models.

  • Figure 3 Pretreatment panoramic radiograph.

  • Figure 4 Pretreatment lateral cephalometric radiograph with tracing.

  • Figure 5 Sagittal cone-beam computed tomography image showing thin mandibular symphysis.

  • Figure 6 Coronal cone-beam computed tomography image showing nasal septum deviation, right turbinate hypertrophy, and left maxillary sinus congestion.

  • Figure 7 Insigna digital setup.

  • Figure 8 Photographs of the leveling and aligning phase.

  • Figure 9 Coronal cone-beam computed tomography image showing complete resolution of upper airway obstruction.

  • Figure 10 Post-treatment photographs.

  • Figure 11 Post-treatment digital dental models.

  • Figure 12 Post-treatment panoramic radiograph.

  • Figure 13 Post-treatment lateral cephalometric radiograph with tracing.

  • Figure 14 Superimposed pretreatment and post-treatment tracings.

  • Figure 15 Tongue elevator for retention.

  • Figure 16 Appearance 3 years 5 months after the treatment.


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